More than 400,00 people with diabetes in England - which is 27.7 per cent of people with type 1 and 13.3 per cent of people with type 2 - do not have a vitally important annual foot check, according to new research.

The study, which is based on data from NHS England, suggests that by not having the foot check, people with diabetes are significantly increasing their risk of amputation.

Foot care is hugely important for people with diabetes, both type 1 and type 2. Over time, prolonged exposure to high blood glucose levels can damage the nerves, leading to reduced feeling and impaired blood circulation. This makes it difficult to notice damage to the feet, so small wounds often get worse, both because the individual does not notice them and because their impaired blood circulation makes the wound heal more slowly.

Ultimately, foot damage in people with diabetic neuropathy can in many cases lead to foot ulcers, which, left untreated, can quickly get worse. They are the leading cause of amputation for people with diabetes.

Regular foot checks, therefore, are the most effective way to prevent amputation in people with diabetes. Beyond getting their annual foot check, people with diabetes should learn how to care for their feet by themselves.

In 2010-2011, it was estimated that foot care costs the NHS around £650 million, with over 100 amputations being performed every week. Following diabetes-related amputation, 80 per cent of people die within five years.

"We know that good diabetes care can dramatically reduce the risk of amputation. The foot check people should get at least once a year is an essential part of this and so it is worrying that more than 400,00 people with diabetes are still not getting one," said Barbara Young, Chief Executive of Diabetes UK.

"Given the high levels of preventable diabetes-related amputations, it is unacceptable that the proportion of people getting the check has hardly changed over recent years. It is one of the reasons so many people with diabetes are forced to endure an amputation and we urgently need to get to a point where everyone with the condition is getting their annual foot check."